03 June 2020 : Case report
Combined Timed Surgery and Conservative Management of Primary Necrotizing Fasciitis of the Breast: A Case Report
Rare diseaseConcetta Anna Dodaro
- A Study design/planning
- B Data collection/entry
Am J Case Rep 2020; 21:e922688
BACKGROUND: Necrotizing fasciitis is a life-threatening infection that involves the deep fascia and the surrounding tissue, but rarely involves the female breast. The most common treatment for necrotizing fasciitis of the breast is total mastectomy. However, the use of negative pressure wound therapy (NPWT), after surgical debridement, is reported to promote the more rapid development of granulation tissue, before reconstructive surgery. This report presents the case of a 53-year-old woman with necrotizing fasciitis of the breast who underwent combined timed surgery and conservative management.
CASE REPORT: A 53-year-old woman presented with necrotizing fasciitis of the right breast, involving the right lateral chest wall and flank. She was referred to the Intensive Care Unit (ICU) of the hospital with septic shock. After hemodynamic stabilization was achieved, she underwent surgical debridement. Excised breast tissues were sent for histology, and intraoperative swabs were collected and sent for microbiological examination. Intravenous antibiotic therapy and hyperbaric oxygen therapy commenced. The patient was managed with NPWT dressings, followed by reconstructive breast surgery. The right chest and flank completely healed.
CONCLUSIONS: This case has shown that early diagnosis and management of necrotizing fasciitis of the breast can be life-saving and may allow for breast conservation. Early aggressive debridement combined with NPWT dressings and reconstructive breast surgery resulted in successful wound healing and preservation of the breast with a satisfactory cosmetic outcome.
Keywords: Breast, Fasciitis, Necrotizing, Negative-Pressure Wound Therapy, Surgery, Plastic, Wound Closure Techniques, Anti-Infective Agents, Combined Modality Therapy, conservative treatment, Middle Aged, Staphylococcal Infections
21 Sep 2023 : Case reportSuccessful Outpatient Treatment of Severe Diabetic-Foot Myositis and Osteomyelitis Caused by Extensively Dr...
Am J Case Rep In Press; DOI: 10.12659/AJCR.941337
21 Sep 2023 : Case reportFulminant Lymphocytic Myocarditis Successfully Managed with Intra-Aortic Balloon Pump and Extracorporeal Me...
Am J Case Rep In Press; DOI: 10.12659/AJCR.941422
21 Sep 2023 : Case reportEmphysematous Cystitis: A Rare Urologic Emergency
Am J Case Rep In Press; DOI: 10.12659/AJCR.941599
Most Viewed Current Articles
06 Dec 2021 : Case reportLipedema Can Be Treated Non-Surgically: A Report of 5 Cases
Am J Case Rep 2021; 22:e934406
07 Dec 2021 : Case reportEdwardsiella tarda: A Classic Presentation of a Rare Fatal Infection, with Possible New Background Risk Fac...
Am J Case Rep 2021; 22:e934347
13 Jul 2022 : Case reportWhistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound
Am J Case Rep 2022; 23:e936441